Osteophyte & jumper's knee

[Terzo]

Recently I was at the doctors for a sort of dull ache in my left knee, and after a referral and x-ray I've been told that I have both a bone spur and jumper's knee.

The doctor referred me to see a physical therapist for a few weeks, but the doctor also told me that it's difficult to get rid of and also painted (in my eyes) a relatively dire picture as he basically said to avoid squatting motions and even went as far as to recommend elevators over stairs. Perhaps I misunderstood him and this was only meant to be until going to pt, or so I hope. I haven't been to pt yet, but in the meantime I some questions that I figure some here may have experience with.

The biggest question on my mind is will it truly be "bad" for me to continue squatting? That's the impression I got, but I'm also hoping I can talk to the people at pt and see if there are measures/exercises/something like that I can do that make squatting "okay".

Another question I have is related to the osteophyte. Is it possible for the bone there to "grow back"? Or is that damage permanent? On a positive note, it sounds like the osteophyte itself is minor in size.

Finally, an insurance question. I'm not 100% positive on this but I believe that I will be responsible for the pt payments as I haven't met my deductible for this cycle yet. I spoke to my insurance who said that outside of annual preventive measures, the deductible applies to everything. However, someone at my office seemed pretty sure that the deductible wouldn't apply to pt.
Does anyone have experience with the insurance aspect? Right now I'm assuming the deductible will come into play. I'm going to check with the pt office, but I think it might be more beneficial for me to offer to pay out of pocket in return for a lower charge.

Thanks in advance for all replies.

 

[SociallyChallenged]

Your doctor's opinion is very, very conservative, especially if it is a small osteophyte... however, it does depend on where the osteophyte is. If it's located at or within the patellar tendon, it's called an enthesophyte. That is not a dire diagnosis, especially if your mechanics are off. If the mechanics of your LE kinetic chain are off, there are a lot of things that can be done for your knee.

Anecdotally, I'm both a physical therapist and I have an enthesophyte at my patellar tendon. I have squatted 350lbs, deadlifted 390lbs, and I can run without issue. I have had previous pain at this location, but it's not terribly difficult to rehab from, especially if your facility has a thoughtful PT.

As it refers to insurance, most insurance companies do count the payment for PT as part of your deductible. I'm not sure who your insurance company is, nor do I know the specifics of your plan. Every patient I see who pays money toward their deductible has it count for all other medical coverage.

 

[Terzo]

Thanks for the input. It may technically be an enthesophyte then, as the doctor was talking about interaction between it and the patellar tendon. While he seemed down on squats, he did say that he wouldn't give basketball up (not that I play often), but even the way he phrased that seemed negative.

My first visit for pt is tomorrow, which I'm a bit more optimistic about now.

 

[SociallyChallenged]

Thanks for the input. It may technically be an enthesophyte then, as the doctor was talking about interaction between it and the patellar tendon. While he seemed down on squats, he did say that he wouldn't give basketball up (not that I play often), but even the way he phrased that seemed negative.

My first visit for pt is tomorrow, which I'm a bit more optimistic about now.

Was this an orthopedic surgeon? It sounds like he hasn't read any biomechanics or tissue stress research in a very long time. Squatting tends to come back quicker than jumping 99% of the time. Jumping is much harder to get back to due to the rapid loading of the tendon, along with the repetitive nature of it. I'd say talk to your PT, ask a lot of questions, and get some answers.

I'd say don't give up on anything until yet until you've made some progress and given it some time.

 

[Terzo]

Perhaps I phrased that poorly. It was an orthopedic specialist I spoke to (referred to him from primary care). Though he does appear to be an older gentleman (guessing in his sixties), I'm going to trust that he keeps up to date.

What he said actually said about basketball was that it was likely one of the causes (in addition to squats). However, when he said he wouldn't give up basketball that was from a personal viewpoint, as in he appreciates the sport a lot and it would be really hard to stop playing.

Looking forward to my first session, in the mean time I've done some armchair research. Seems like "eccentric exercises", or most commonly squats at a 25-30 degree decline, are gonna be recommended.

 

[Terzo]

Just an update, I went to PT and for the most part it seems I overreacted.

I was told that overall I'm pretty healthy and there's no big concerns. Since this was a "recurring" issue (it happened once before, then flared up again more recently), the PT said I probably didn't give the leg enough rest, which aggravated it and made it worse. He gave me a large number of exercises to do to help out with leg strength and flexibility.

For now I'll just be doing those exercises and simple cardio (mostly rowing since i have an concept 2 at my place), then in around a month's time I'll start getting back into things.